Hepatic hemangioma natural history, complications and prognosis: Difference between revisions
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*In the worldwide literature a total of only 97 cases with a rupture of a hemangioma have been published, whereas a spontaneous rupture only happened in 47.4% of cases.<ref name="DonatiStavrou2011">{{cite journal|last1=Donati|first1=Marcello|last2=Stavrou|first2=Gregor A.|last3=Donati|first3=Angelo|last4=Oldhafer|first4=Karl J.|title=The risk of spontaneous rupture of liver hemangiomas: a critical review of the literature|journal=Journal of Hepato-Biliary-Pancreatic Sciences|volume=18|issue=6|year=2011|pages=797–805|issn=18686974|doi=10.1007/s00534-011-0420-7}}</ref><ref name="EhrlRothaug2012">{{cite journal|last1=Ehrl|first1=Denis|last2=Rothaug|first2=Katharina|last3=Herzog|first3=Peter|last4=Hofer|first4=Bernhard|last5=Rau|first5=Horst-Günter|title=“Incidentaloma” of the Liver: Management of a Diagnostic and Therapeutic Dilemma|journal=HPB Surgery|volume=2012|year=2012|pages=1–14|issn=0894-8569|doi=10.1155/2012/891787}}</ref> | *In the worldwide literature a total of only 97 cases with a rupture of a hemangioma have been published, whereas a spontaneous rupture only happened in 47.4% of cases.<ref name="DonatiStavrou2011">{{cite journal|last1=Donati|first1=Marcello|last2=Stavrou|first2=Gregor A.|last3=Donati|first3=Angelo|last4=Oldhafer|first4=Karl J.|title=The risk of spontaneous rupture of liver hemangiomas: a critical review of the literature|journal=Journal of Hepato-Biliary-Pancreatic Sciences|volume=18|issue=6|year=2011|pages=797–805|issn=18686974|doi=10.1007/s00534-011-0420-7}}</ref><ref name="EhrlRothaug2012">{{cite journal|last1=Ehrl|first1=Denis|last2=Rothaug|first2=Katharina|last3=Herzog|first3=Peter|last4=Hofer|first4=Bernhard|last5=Rau|first5=Horst-Günter|title=“Incidentaloma” of the Liver: Management of a Diagnostic and Therapeutic Dilemma|journal=HPB Surgery|volume=2012|year=2012|pages=1–14|issn=0894-8569|doi=10.1155/2012/891787}}</ref> | ||
*Further investigation showed that these spontaneously ruptured hemangiomas had a mean size of 11.2 cm.<ref name="EhrlRothaug2012">{{cite journal|last1=Ehrl|first1=Denis|last2=Rothaug|first2=Katharina|last3=Herzog|first3=Peter|last4=Hofer|first4=Bernhard|last5=Rau|first5=Horst-Günter|title=“Incidentaloma” of the Liver: Management of a Diagnostic and Therapeutic Dilemma|journal=HPB Surgery|volume=2012|year=2012|pages=1–14|issn=0894-8569|doi=10.1155/2012/891787}}</ref><ref name="DonatiStavrou2011">{{cite journal|last1=Donati|first1=Marcello|last2=Stavrou|first2=Gregor A.|last3=Donati|first3=Angelo|last4=Oldhafer|first4=Karl J.|title=The risk of spontaneous rupture of liver hemangiomas: a critical review of the literature|journal=Journal of Hepato-Biliary-Pancreatic Sciences|volume=18|issue=6|year=2011|pages=797–805|issn=18686974|doi=10.1007/s00534-011-0420-7}}</ref> | *Further investigation showed that these spontaneously ruptured hemangiomas had a mean size of 11.2 cm.<ref name="EhrlRothaug2012">{{cite journal|last1=Ehrl|first1=Denis|last2=Rothaug|first2=Katharina|last3=Herzog|first3=Peter|last4=Hofer|first4=Bernhard|last5=Rau|first5=Horst-Günter|title=“Incidentaloma” of the Liver: Management of a Diagnostic and Therapeutic Dilemma|journal=HPB Surgery|volume=2012|year=2012|pages=1–14|issn=0894-8569|doi=10.1155/2012/891787}}</ref><ref name="DonatiStavrou2011">{{cite journal|last1=Donati|first1=Marcello|last2=Stavrou|first2=Gregor A.|last3=Donati|first3=Angelo|last4=Oldhafer|first4=Karl J.|title=The risk of spontaneous rupture of liver hemangiomas: a critical review of the literature|journal=Journal of Hepato-Biliary-Pancreatic Sciences|volume=18|issue=6|year=2011|pages=797–805|issn=18686974|doi=10.1007/s00534-011-0420-7}}</ref> | ||
*Despite therapy, in these situations the mortality rate is 30-40%.<ref name="EhrlRothaug2012">{{cite journal|last1=Ehrl|first1=Denis|last2=Rothaug|first2=Katharina|last3=Herzog|first3=Peter|last4=Hofer|first4=Bernhard|last5=Rau|first5=Horst-Günter|title=“Incidentaloma” of the Liver: Management of a Diagnostic and Therapeutic Dilemma|journal=HPB Surgery|volume=2012|year=2012|pages=1–14|issn=0894-8569|doi=10.1155/2012/891787}}</ref> | |||
*Hemangiomas generally have no growth tendency. In the literature, however, cases of hemangioma growth during pregnancy or after estrogen administration are described.<ref name="Assy2009">{{cite journal|last1=Assy|first1=Nimer|title=Characteristics of common solid liver lesions and recommendations for diagnostic workup|journal=World Journal of Gastroenterology|volume=15|issue=26|year=2009|pages=3217|issn=1007-9327|doi=10.3748/wjg.15.3217}}</ref><ref name="EhrlRothaug2012">{{cite journal|last1=Ehrl|first1=Denis|last2=Rothaug|first2=Katharina|last3=Herzog|first3=Peter|last4=Hofer|first4=Bernhard|last5=Rau|first5=Horst-Günter|title=“Incidentaloma” of the Liver: Management of a Diagnostic and Therapeutic Dilemma|journal=HPB Surgery|volume=2012|year=2012|pages=1–14|issn=0894-8569|doi=10.1155/2012/891787}}</ref> | *Hemangiomas generally have no growth tendency. In the literature, however, cases of hemangioma growth during pregnancy or after estrogen administration are described.<ref name="Assy2009">{{cite journal|last1=Assy|first1=Nimer|title=Characteristics of common solid liver lesions and recommendations for diagnostic workup|journal=World Journal of Gastroenterology|volume=15|issue=26|year=2009|pages=3217|issn=1007-9327|doi=10.3748/wjg.15.3217}}</ref><ref name="EhrlRothaug2012">{{cite journal|last1=Ehrl|first1=Denis|last2=Rothaug|first2=Katharina|last3=Herzog|first3=Peter|last4=Hofer|first4=Bernhard|last5=Rau|first5=Horst-Günter|title=“Incidentaloma” of the Liver: Management of a Diagnostic and Therapeutic Dilemma|journal=HPB Surgery|volume=2012|year=2012|pages=1–14|issn=0894-8569|doi=10.1155/2012/891787}}</ref> | ||
*Hemangiomas less than 10 cm should generally not be treated, even before a pregnancy. In case of a planned pregnancy and a size more than 10 cm, due to the risk of a possible rupture, a definitive treatment should be discussed.<ref name="EhrlRothaug2012">{{cite journal|last1=Ehrl|first1=Denis|last2=Rothaug|first2=Katharina|last3=Herzog|first3=Peter|last4=Hofer|first4=Bernhard|last5=Rau|first5=Horst-Günter|title=“Incidentaloma” of the Liver: Management of a Diagnostic and Therapeutic Dilemma|journal=HPB Surgery|volume=2012|year=2012|pages=1–14|issn=0894-8569|doi=10.1155/2012/891787}}</ref><ref name="Assy2009">{{cite journal|last1=Assy|first1=Nimer|title=Characteristics of common solid liver lesions and recommendations for diagnostic workup|journal=World Journal of Gastroenterology|volume=15|issue=26|year=2009|pages=3217|issn=1007-9327|doi=10.3748/wjg.15.3217}}</ref> | |||
*Several studies have concluded that a spontaneous rupture of a hemangioma (even while pregnancy) occurs only very rarely.<ref name="EhrlRothaug2012">{{cite journal|last1=Ehrl|first1=Denis|last2=Rothaug|first2=Katharina|last3=Herzog|first3=Peter|last4=Hofer|first4=Bernhard|last5=Rau|first5=Horst-Günter|title=“Incidentaloma” of the Liver: Management of a Diagnostic and Therapeutic Dilemma|journal=HPB Surgery|volume=2012|year=2012|pages=1–14|issn=0894-8569|doi=10.1155/2012/891787}}</ref> | *Several studies have concluded that a spontaneous rupture of a hemangioma (even while pregnancy) occurs only very rarely.<ref name="EhrlRothaug2012">{{cite journal|last1=Ehrl|first1=Denis|last2=Rothaug|first2=Katharina|last3=Herzog|first3=Peter|last4=Hofer|first4=Bernhard|last5=Rau|first5=Horst-Günter|title=“Incidentaloma” of the Liver: Management of a Diagnostic and Therapeutic Dilemma|journal=HPB Surgery|volume=2012|year=2012|pages=1–14|issn=0894-8569|doi=10.1155/2012/891787}}</ref> | ||
==Complications== | ==Complications== | ||
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*[[Pregnancy]] and [[estrogen]]-based medications can cause [[cavernous hemangioma]]s to grow. | *[[Pregnancy]] and [[estrogen]]-based medications can cause [[cavernous hemangioma]]s to grow. | ||
==Prognosis== | ==Prognosis== | ||
Prognosis is generally excellent, and the mortality rate of patients with spontaneous rupture of hepatic hemangioma is approximately 30-40% despite therapy.<ref name="EhrlRothaug2012">{{cite journal|last1=Ehrl|first1=Denis|last2=Rothaug|first2=Katharina|last3=Herzog|first3=Peter|last4=Hofer|first4=Bernhard|last5=Rau|first5=Horst-Günter|title=“Incidentaloma” of the Liver: Management of a Diagnostic and Therapeutic Dilemma|journal=HPB Surgery|volume=2012|year=2012|pages=1–14|issn=0894-8569|doi=10.1155/2012/891787}}</ref> | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 15:47, 9 November 2015
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Nawal Muazam M.D.[2]
Overview
Hepatic hemangioma natural history
- Hepatic hemangioma is the most common benign liver tumor and typically remains stable in size.[1]
- These are usually diagnosed as asymptomatic incidental findings.
- Hemangiomas also (rarely) rupture spontaneously or by trauma and then lead to acute hemorrhagic shock with upper abdominal pain.[2][3]
- In the worldwide literature a total of only 97 cases with a rupture of a hemangioma have been published, whereas a spontaneous rupture only happened in 47.4% of cases.[4][3]
- Further investigation showed that these spontaneously ruptured hemangiomas had a mean size of 11.2 cm.[3][4]
- Despite therapy, in these situations the mortality rate is 30-40%.[3]
- Hemangiomas generally have no growth tendency. In the literature, however, cases of hemangioma growth during pregnancy or after estrogen administration are described.[2][3]
- Hemangiomas less than 10 cm should generally not be treated, even before a pregnancy. In case of a planned pregnancy and a size more than 10 cm, due to the risk of a possible rupture, a definitive treatment should be discussed.[3][2]
- Several studies have concluded that a spontaneous rupture of a hemangioma (even while pregnancy) occurs only very rarely.[3]
Complications
Complications of hepatic hemangioma include:[2][3]
- Spontaneous rupture
- Acute hemorrhagic shock
- Upper abdominal pain
- Pregnancy and estrogen-based medications can cause cavernous hemangiomas to grow.
Prognosis
Prognosis is generally excellent, and the mortality rate of patients with spontaneous rupture of hepatic hemangioma is approximately 30-40% despite therapy.[3]
References
- ↑ Maruyama, Masaki; Isokawa, Osamu; Hoshiyama, Koki; Hoshiyama, Ayako; Hoshiyama, Mari; Hoshiyama, Yoshihiro (2013). "Diagnosis and Management of Giant Hepatic Hemangioma: The Usefulness of Contrast-Enhanced Ultrasonography". International Journal of Hepatology. 2013: 1–6. doi:10.1155/2013/802180. ISSN 2090-3448.
- ↑ 2.0 2.1 2.2 2.3 Assy, Nimer (2009). "Characteristics of common solid liver lesions and recommendations for diagnostic workup". World Journal of Gastroenterology. 15 (26): 3217. doi:10.3748/wjg.15.3217. ISSN 1007-9327.
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 Ehrl, Denis; Rothaug, Katharina; Herzog, Peter; Hofer, Bernhard; Rau, Horst-Günter (2012). ""Incidentaloma" of the Liver: Management of a Diagnostic and Therapeutic Dilemma". HPB Surgery. 2012: 1–14. doi:10.1155/2012/891787. ISSN 0894-8569.
- ↑ 4.0 4.1 Donati, Marcello; Stavrou, Gregor A.; Donati, Angelo; Oldhafer, Karl J. (2011). "The risk of spontaneous rupture of liver hemangiomas: a critical review of the literature". Journal of Hepato-Biliary-Pancreatic Sciences. 18 (6): 797–805. doi:10.1007/s00534-011-0420-7. ISSN 1868-6974.